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Evidence from physiological studies indicates that hypoxia may act as a stress that reduces fecundity; and in human populations resident at high altitude there is evidence of reduced fertility (James, 1966) In this paper the fertility of high Andean populations is described with reference to the ecological and social context. An analysis of high Andean energy flow (Thomas, 1972) indicates that children are an economic asset, and consideration of the social organization of high Andean rural communities supports this view. A study of the fertility of migrants from high to low altitude indicates that reproductive performance increases with the removal of the stress of hypoxia (Abelson et al. 1974). It is therefore concluded that the reduced fertility observed in high Andean populations is due to the effect of hypoxia on human fecundity.